20170301101528.pdf01 L 1) �vl
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
STATUS: ISSUED 03/01/2017 Permit #: BLD20170299
Expiration Date: 09/01/2017 Project Address: 17030 TALBOT RD, EDMONDS
Parcel No: 27040700102900
LOUISE GERTH
FILCO COMPANY INC
FILCO COMPANY INC
11443 SE 164TH ST
CIO TIM AYRES
CIO TIM AYRES
RENTON, WA 98055-5213
PO BOX 31228
PO BOX 31228
SEATTLE, WA 98103
SEATTLE, WA 98103
(425) 226-2656
(206) 547-8347
(206) 547-8347
LICENSE #: filcocio80ru EXP:10/10/2017
PUMP OUT, EXCAVATE AND REN40VE ONE 500 GALLON RESIDENTIAL HEATING OIL TANK. BACK FILL, HAUL TANK AND
PROPERLY DISPOSE.
VALUATION: $0.00
PERMIT TYPE: Residential
PERMIT GROUP: 70 - Tanks/Fuel
GRADING: N CYDS: 0
TYPE OF CONSTRUCTION
RETAINING WALL ROCKERY
OCCUPANT GROUP
OCCUPANT LOAD:
FENCE OXO FT)
CODE: 2015
OTHER: ------- OTHER DESC:
ZONE:
NUMBER OF STORIES: 0
VESTED DATE:
N' 1. 1 M BE R OF DWELLING UNIT S: 0
LOT #:
�MLIMMMIN
BA,SEMFNT- 0 1 ST FLOOR- 0 2ND FLOOR: 0
piramm"alm
BASEMENT: 0 1 ST FLOOR: 0 2ND FLOOR: 0
3RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
.3RD FLOOR� 0 GARAGE: 0 DECK: 0 OTHER: 0
IBEDROOMS: 0 BATHROOMS: 0
1 BEDROOMS: 0 BATHROOMS: 0
FRONTS FFRA('K SIDESFFBACK RLAR S ETB AUK
REQUIRED: PROPOSED: ��REQUIRED: PROPOSED: I REQ71RED: PROPOSED
HEIGHT ALLOWED:O PROPOSED:O IREQUIRED: PROPOSED:
SETBACK NOTES:
I AGREE TO COMPLY WITH CITY AND STATE LAWS REG[JLAT ING CONSTRUCTION AND IN DOINGTHE WORK AUTHORIZED
THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATINGTO
WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27.
THIS APPLICATION ISNOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HISIHER DEPUTY AND ALL FEES ARE PAID
I I
krjS�jij c7ohijS 03111,?LI)17
Siqna0p/ Print Name Date Released By Date
ATTENTION
ITIS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL ORA CERTIFICATE OF
OCCUPANCY HAS BEEN GRANTED. UBC109/ IBC1 10/ IRCI 10
ONUNE APPUCANT ASSESSOR 1-<-] OTHER
-STATUS: ISSUED BLD20170299
CONI)ITIONS
• Final approval on a project or final occupancy approval must be granted by the Building Official prior to use or occupancy of
the building or structure. Check thejob card for all required City inspections including final project approval and final
occupancy inspections.
• Any request for alternate design, modification, variance or other administrative deviation (hereinafter "variance") from
adopted codes, ordinances or policies must be specifically requested in writing and be called out and identified. Processing
fees for such request shall be established by Council and shall be paid upon submittal and are non-refundable.
Approval of any plat or plan containing provisions which do not comply with city code and for which a variance has not been
specifically identified, requested and considered by the appropriate city official in accordance with the appropriate provision
of city code or state law does not approve any items not to code specification.
Sound/Noise originating from temporary construction sites as a result of construction activity are exempt from the noise limits
of ECC Chapter 5.30 only during the hours of 7:00amto 6:00pm on weekdays and 10:00arn and 6:00pm on Saturdays, excluding
Sundays and Federal Holidays. At all othertimes the noise originating from construction sites/activities must comply with the
noise limits of Chapter 5.30, unless a variance has been granted pursuant to ECC 5.30.120.
Applicant, on behalf of his or her spouse, heirs, assigns, and successors in interests, agrees to indemnify defend and hold
harmless the City of Edmonds, Washington, its officials, employees, and agents from any and all claims for damages of
whatever nature, arising directly or indirectly fromthe issuance for this permit. Issuance ofthis permit shall not be deemed to
modify, waive or reduce any requirements of any City ordinance nor limit in any way the City's ability to enforce any ordinance
provision.
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE
PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION.
PERMIT TIME LIMIT: SEE ECDC 19.00.005(A)(6)
771-0220 EXT. 1333 1 ENGENEERING (425) 771-0220 EXT. 1326
I PUBLIC WORKS (425) 771-0235 1 PR&TREATMENT (425) 672-5755 1 11F)CYCLING (425) 2754801 1
When calling for an inspection please leave the folloming information: Permit Number, Job Site Address, Type of Inspection being
requested, Contact Name and Phone Number, Date Prefereed, and mbether you prefer morninp, or afternoon.
. F-Fire Final
DEVELOPMENT SERVICES
PLUMBING, MECHANICAL, TANK, & DEMOLITION
PERMIT APPLICATION
121 5b Avenue N, Edmonds, WA 98020
Phone 425.771.0220 2 Fax 425.771.0221
City of Edmonds
PLEASE REFER TO THE PLUMBING & ME��ICAL CHECKLIST FOR SUBMITTAL REQUIREMENTS
PROJECT ADDRESS (Street, Suite #, City State, Zip):
Parcel #:
17030 Talbot Road, Edmonds, WA 98026
27040700102900
IS THIS WORK ASSOCIATED WITH ANOTHER PROJECT? Yes[] NoF.71
Associated Permit #:
APPLICANT:
Phone:
TN-7548-9352
Filco Company Inc.
206-547-8347
Address (Street, City, State, Zip):
E-Mail Address:
PO Box 31228 Seattle, Washington 98103
info@filcoenviro.com
PROPERTY OWNER:
Phone:
Allen Gerth
425-226-2656
Address (Street, City, State, Zip):
E-Mail Address:
17030 Talbot Road, Edmonds, WA 98026
LENDING AGENCY:
Phone:
Fax:
Address (Street, City, State, Zip):
E-Mail Address:
CONTRACTOR:*
Phone:
Fax:
Filco CornjpanV Inc.
206-547-8347
106-548-9352
Address (Street, City, State, Zip):
E-Mail Addiess:
PO Box 31228, Seattle, Washington 98026
info@filcoenviro.com
WA State License #/Exp. Date:
*Contractor must have a valid City ofEdnionds business license prior to doing work
FILCOCIO80RU
in the City. Contact the City Clerk's Office at 425.775.2525
City Business License #/Exp. Date:
NR-02053,3
PLUMBING MECHANICAL 6,"TAN&K�V�l
DEMOLITION
DETAIL THE SCOPE OF WORK: Pump out, excavate and remove one 500 gallon residential
heating oil tank. Back fill. excavation, haul tank away and properly dispose of tank.
I declare underpenalty ofperjury laws that the information I haveprovided on thisformlapplication is true, correct and complete,
and that I am theproperly owner or duly authorized agent of theproperty owner to submit apermit application to the City of
Edmonds.
5
Print Name: Im OwnerE]Agent/Other
Z (specify): Contractor
Signature: ZAA41 I" 4Z7 Date:
7
FOR M C. T Mv PMA., ')AI ffinf')XIP R, —r—el tn T r, )nl A A— 1 11-1 1
MEDICAL -GAS, AIR, VACUUM
Type of Gas/AirNacuum System (new and relocated)
Total#
Oxygen
Nitrous Oxide
Medical Air
Carbon Dioxide
Helium
Medical — Surgical Vacuum
Other:
TOTAL OUTLETS
TANK#1
TANK #2
Method of Abandonment
Method of Abandonment
Fill in PlaceF]
Fill Material
Fill in Place
F
Fill Material
Remwiii 1
Removal I I
Number Gallons:
Number of Gallons: 5 00 gallon
Critical Areas Determination: Study RequiredFv—(]
-of
Conditional Waiver El
waiver
W]
CRA20160143
I U Will Uwawww_L"
Type of structure to be demolished (e.g. house, shed, garage, etc.):
Floor area of structure to be demolished: sq. ft.
Critical Areas Determination: Study RequiredEl Conditional WaiverEl Waiver 1:1
PSCAA Case No.
AHERA Survey done? (required)
Additional comments:
P(-)I?A)r (' T n_ I A __ 1—M-11 . .' r - — - A — � � — A _ , . I . I I .. ---. .
FILCO COMPANY INC.
PO BOX 31228
SEATTLE, WA 98103
LICENSE#FILCOCIO80RU EXP: 10/10/2017
ICC LICENSE # 8145449
SITE PLAN
HEATING OIL TANK DECOMMISSIONING
JOB SITE ADRESS: 17030 Talbot Road, Edmonds WA 98026
OWNER: Allen Gerth
PHONE: 425-226-2656
ACTIVM: Pump out tank, rinse and remove and replace one 500 gallon residential heating oil tank.
17030— House
Dor -h
Garage
Walkway
Garden area Driveway
Gravel
Talbot Road